Provider Demographics
NPI:1295912277
Name:LIN, ERINA MAY (MD)
Entity type:Individual
Prefix:
First Name:ERINA
Middle Name:MAY
Last Name:LIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1131 WILSHIRE BLVD
Mailing Address - Street 2:SUITE # 202
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2061
Mailing Address - Country:US
Mailing Address - Phone:310-825-0867
Mailing Address - Fax:424-259-8571
Practice Address - Street 1:1131 WILSHIRE BLVD
Practice Address - Street 2:SUITE # 202
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90401
Practice Address - Country:US
Practice Address - Phone:310-825-0867
Practice Address - Fax:424-259-8571
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2014-04-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA77793207K00000X, 207KI0005X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207KI0005XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyClinical & Laboratory Immunology
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A77930Medicaid
CAA77793OtherMEDICAL LIC
CAA77793OtherMEDICAL LIC